Provider Demographics
NPI:1316072523
Name:CREAL, STEPHEN MOSS (STEPHEN CREAL DDS)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:MOSS
Last Name:CREAL
Suffix:
Gender:M
Credentials:STEPHEN CREAL DDS
Other - Prefix:DR
Other - First Name:STEVE
Other - Middle Name:
Other - Last Name:CREAL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:STEPHEN CREAL
Mailing Address - Street 1:2001 S SHIELDS ST
Mailing Address - Street 2:BLDG C
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80526-1827
Mailing Address - Country:US
Mailing Address - Phone:970-482-2442
Mailing Address - Fax:970-482-2443
Practice Address - Street 1:2001 S SHIELDS ST
Practice Address - Street 2:BLDG C
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80526-1827
Practice Address - Country:US
Practice Address - Phone:970-482-2442
Practice Address - Fax:970-482-2443
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6813122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist